Download PDF. 1 / 3 Pages. Previous article. Go back to website. Next article. HARRIS D., Paul BRINCK M., Patricio. Un análisis retrospectivo de cavernomatosis de la vena porta en Chile: II. Hemorragia, tratamiento y pronóstico. Rev. chil. HARRIS D., Paul BRINCK M., Patricio. Un análisis retrospectivo de cavernomatosis de la vena porta en Chile.: I. Perfil clínico y de laboratorio. Rev. chil. pediatr.

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Although in the general population PVT is considered a rare event, its prevalence among cirrhotic patients ranges between 4. Intestinal congestion and ischemia, with abdominal pain, diarrhea, rectal bleeding, abdominal distention, nausea, vomiting, anorexia, fever, lactacidosis, sepsis, and splenomegaly are common features of acute PVT.

Transjugular intrahepatic portosystemic shunt. As this phenomenon is strictly time-dependent, it is advisable to screen all PVT patients endoscopically, at diagnosis[ 63 ].

Malformación cavernomatosa de la vena porta

HPB Oxford ; 9: Inherited coagulation disorders in cirrhotic favernoma with portal vein thrombosis. Recent portal or mesenteric venous thrombosis: Complete thrombosis of both portal and proximal superior mesenteric vein.

In addition, MR angiography has a high accuracy in the follow-up of the portal venous system before and after liver transplantation[ 82 – 85 ].

Instead, a rapid and complete obstruction of the portal or mesenteric vein, without the involvement of the mesenteric venous arches, induces only intestinal congestion; the main feature is a diffuse thickening of the intestinal wall, visible even without alterations in contrast enhancement.

Deficiency of natural anticoagulant proteins C, S, and antithrombin in portal vein thrombosis: Role of the JAK2 mutation in the diagnosis of chronic myeloproliferative disorders in splanchnic vein thrombosis. Finally, the role of oral contraceptives, steroids, and pregnancy is still less clear[ 45 – 47 ]. Open in a separate window. oa


In conclusion, it is reasonable to routinely investigate the most common prothrombotic disorders and exclude a local trigger, to provide a correct management of PVT and its original cause.

Consider a diagnosis of acute PVT in any patient with abdominal pain of more than 24 h duration, whether or not there is also fever or ileus. On physical examination, the abdomen might be distended, but guarding is rare, except in case of intra-abdominal inflammation, intestinal infarction, and perforation[ 22 ].

Otherwise, prognosis depends on the underlying liver disease[ 1122279 ]. Coagulation abnormalities in malignancy: Changing perspectives in portal vein thrombosis and liver transplantation. Transjugular intrahepatic portosystemic shunt TIPS in the treatment of venous symptomatic chronic portal thrombosis in non-cirrhotic patients.

After liver transplantation, PVT development is a rare but possible event, especially in the early postoperative period[ 60 ]. However, this process results in a progressive loss of tissue and might be responsible for the impairment of hepatic synthetic function observed in advanced stages of portal vein obstruction[ 11 ].

The history of PVT has been characterized by difficulties in diagnosis and treatment, which, today, have almost been overcome. It seems to be effective in resolving portal biliopathy, ascites, and portal hypertension, but it is not feasible if pkrta vein is not catheterizable or a cavernomatous vein cannot be dilated[ – ].

Portal vein thrombosis: Insight into physiopathology, diagnosis, and treatment

Magnetic resonance portal venography: Advanced disease in the absence of obvious precipitating factors. N Engl J Med. Although spontaneous resolution of PVT has been reported in the literature[], a specific therapeutic portz is mandatory to resolve portal vein obstruction and avoid serious complications.

Percutaneous transhepatic treatment of symptomatic mesenteric venous thrombosis.

Portal vein thrombosis: Insight into physiopathology, diagnosis, and treatment

J Cancer Res Clin Oncol. Moreover, a homozygous methylene tetrahydrofolate cvaernoma MTHFR gene mutation might be associated with PVT development alone or, if heterozygote, in the presence of other cofactors[ 1335 – 39 ]. A prospective multicentric follow-up study on patients with acute portal vein thrombosis PVT: Risk factors of thrombosis in abdominal veins. Comparisons of technical difficulties, postoperative complications, survival, and mortality, in recipients with or without PVT are contrasting.


Furthermore, patients with an obstruction of more than half of the portal vein, extended or not to the superior mesenteric vein, seem to have increased risk of severe peri-operative complications, higher mortality, and decreased long-term survival[ 85, ]. All these manifestations are completely reversible, even if a spontaneous recanalization or a cavernomatous transformation occurs.

The use of EUS to diagnose malignant portal venous system invasion by pancreatic cagernoma. Portal vein thrombosis after variceal endoscopic sclerotherapy in cirrhotic patients: Single center porat of 39 patients with preoperative portal vein thrombosis among adult living donor liver transplantations.

Frequently, more than one risk factor could be identified; however, occasionally no single factor is discernable. Am J Clin Pathol.

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Biliary obstruction caused by portal cavernoma: In fact, when thrombosis is extended to both portal and mesenteric veins, dw risk of bowel ischemia is considerable and mortality high, despite a lower risk of variceal bleeding[ 61 ]. The majority of patients exhibit splenomegaly, while ascites is rare or, eventually, present before the development of a collateral circulation.

Thus, PVT seems more frequent than expected: Epub ahead of print.

It has been demonstrated in rats, that the progressive obliteration of the portal vein stimulates apoptosis of hepatocytes in the hypoperfused lobe[ 10 ], while increasing the mitotic activity in the normal perfused one.